The proposed research is designed to provide a new perspective on patient care in nursing homes through a comprehensive case study of the people who do the caring, health service workers. By viewing these employees as workers, rather than simply caregivers, theoretical insights from the study of work can be applied. Focusing on nurse's aides in one New York City nursing home, the research will attempt to show that the analysis of nursing home workers must go beyond the examination of features of the work situation to understand why they act the way they do in caring for patients. Three other, interconnected, factors must also be considered: the workers' roles and positions outside the nursing home; their views of work, their patients, and themselves; and patterns of interaction with coworkers and supervisors. The methods to be used are participant observation in one New York City nursing home for an eight month period and semi-structured indepth interviews with fifty nurse's aides from the facility. The research has potential ethnographic, theoretical, and practical contributions. By rounding out our understanding of nursing home employees, it can be helpful to those developing programs to improve the quality of patient care in nursing homes.